EP0809988A1 - Universal wrist orthosis - Google Patents

Abstract

The wrist support consists of a supple envelope (2) which extends from the metacarpal-phalangeal joints of the hand to a point beyond the wrist and is equipped with a number of parallel lengthwise pockets (12a,12b) to receive splints. The support can be fitted to either hand with the splints located along the back or palm of the hand, and is fastened with strips of hook and loop pile fabric. The pouches for the splints are situated along the central part of the envelope. They are closed at their proximal ends and open at their distal ends to receive the splints, each of which has a curved section at its distal end, shaped to fit the back or front of the hand. The splints can be inserted, removed or reversed at will, according to requirements.

Description

The invention relates to a universal wrist orthosis, that is to say ambidextrous and dorsal or palmar, intended to immobilize the wrist while leaving freedom of movement to the phalanges alone.

It relates more particularly to orthoses composed of a flexible envelope extending longitudinally from the metacarpophalangeal joints to below the wrist and comprising several longitudinal pockets, parallel and juxtaposed for ribs.

It is recalled that the length of the metacarpals is decreasing from outside to inside, as shown by the dashed lines in Figures 1 and 2 attached, representing respectively, a left hand seen from below, that is to say in palm structure, and a left hand seen from above, that is to say in a dorsal situation. Because of this, any orthosis intended to immobilize the wrist while leaving a freedom of movement to the phalanges of the fingers, must take into account this anatomical particularity.

In practice, existing orthoses are difficult to adjust, unless you multiply the number of models depending on the diversity of hand sizes, the application on a left or right hand and the dorsal or palmar use.

This is the case for the immobilization orthosis described in US-A-4 883 073 which, either right or left, can only be used with its main splint in the dorsal position, and of the wrist support, and not immobilization, described in US-A-5 267 943 which, also right or left, can only be placed with its elastic ribs in the palmar position.

Likewise, the wrist, described in US-A-5,513,657, provides only support and not immobilization, because of its shape, its position and the use of flexible whales, arranged in parallel pockets. closed, and has a single use for a right or left hand.

The support orthosis described in US-A-5,014,689 comprises an envelope which extends from the metacarpophalangeal joints to below the wrist, and which is provided in its dorsal and palmar parts with pockets containing flexible whales. This orthosis is for single use, right hand or left hand and is not reversible. In addition, the distal and palmar part of its envelope comes in front of the line of articulation S and hinders the downward movement of the phalanges.

To satisfy the diversity of sizes, these orthoses must also be produced in a large number of models.

To limit this number of models, resulting in high manufacturing and inventory management costs, ambidextrous, straight or left, or multipurpose, namely usable in palmar or dorsal position. However, this increase in the possibilities of use necessitated important concessions on the adaptation to the asymmetry of the hand, to the detriment of the effectiveness of the immobilization of the wrist or of the freedom of movement of the phalanges.

The object of the present invention is to provide a universal orthosis, covering, by a number of very reduced models, all of the applications and uses, while ensuring excellent immobilization of the wrist and leaving complete freedom of movement for the phalanges.

This orthosis is also of the type in which the envelope has at least locally plies of velvet with loops capable of cooperating with plies of velvet with hooks carried by transverse holding straps.

In the orthosis according to the invention, the pockets, are made in the central part of the envelope adapted to come on the back of the hand or under the hand, are provided with proximal ends, closed and parallel, and open distal ends, while, firstly, the ribs are each provided with a bent distal part capable of marrying the back or the inside of the hand, are rigid, removable and returnable in their pocket, and have different lengths so that, when fully engaged in their respective pockets, the straight line S joining their distal ends is substantially parallel to the axis of distribution of the metacarpophalangeal joints, that secondly, the envelope is extended au- beyond the open part of the pockets by a closing flap provided with hooking means on the pockets and a flexible hinge capable, by pressing on the distal end of the ribs, of being folded substantially parallel parallel to the axis of distribution of the metacarpophalangeal joints, plumb with which this hinge is disposed, and that, thirdly, the holding straps are independent of the envelope and include a distal strap passing between thumb and index finger and two transverse straps, respectively, intermediate and proximal.

To adapt the orthosis by hand, right or left, and to the type of use, palmar or dorsal, it suffices to modify the relative position of the ribs in the pockets, so that when folding the flap, the edge of the hinge has substantially the same inclination as that of the distribution of the metacarpophalangeal joints.

The ribs are turned on themselves when passing from the dorsal position to the palmar position, or vice versa, so that their bent ends follow the camber of the back of the hand or of the palm of the hand.

In one embodiment of the invention, the pockets consist of a pile of looped velvet attached to the flexible envelope, while the flap, also consisting of a pile of loop pile of which the loops are external, comprises , on the inner face of its end, a sheet of hooks able to cooperate with the loops of the pockets.

These closing means make it possible to ensure the connection of the flap with the envelope, whatever the angle of the hinge.

Advantageously, the envelope is composed, on the skin side, of a sheet of hypoallergenic material and, on the outside, of a sheet having external loops over its entire surface and constituting attachment means for the ends, provided with hook sheet , of the three independent straps, respectively anterior, intermediate and posterior.

Thus, the envelope is independent of its fastening straps on the hand which can thus be positioned according to the morphology of the hand. More specifically, the distal strap passing between the thumb and forefinger and against the palm or back of the hand, effectively contributes to the longitudinal positioning of the orthosis relative to the metacarpophalangeal joints, but also to the longitudinal immobilization of the orthosis on the wrist and this in combination with the intermediate strap, which can be placed in the immediate vicinity of the thumb to ensure perfect wedging of the orthosis.

The combination of fishplates of different lengths, which can be positioned as required, the general structure of the orthosis and the three independent straps, allows, with a limited range of sizes, to adapt this orthosis to all applications, whether by hand either right or left and whether the support is palmar or dorsal, thus giving this orthosis a versatile character, while ensuring immobilization of the wrist and total freedom of the phalanges.

• Figures 1 et 2 sont des vues respectivement en plan par dessous et en plan par dessus d'une main gauche,
• Figures 3 et 4 sont des vues en plan par dessus de l'orthèse selon l'invention, lorsqu'elle est conformée, respectivement, pour une application palmaire contre la main de figure 1, et pour une application dorsale contre la main de figure 2,
• Figures 5 et 6 sont des vues de côté montrant la position des éclisses dans le cas d'une application palmaire et dorsale,
• Figure 7 est une vue en plan par dessus montrant les différents éléments composant l'orthèse,
• Figure 8 est une vue en plan par dessus de l'enveloppe lorsqu'elle est à plat,
• Figures 9 et 10 sont des vues en perspective montrant l'orthèse lorsqu'elle est mise en place et sanglée, respectivement dans le cadre d'une application dorsale et dans le cadre d'une application palmaire.

Other characteristics and advantages will emerge from the description which follows with reference to the appended schematic drawing representing an embodiment of this orthosis.

• Figures 1 and 2 are plan views from below and plan views respectively with a left hand,
• Figures 3 and 4 are plan views from above of the orthosis according to the invention, when it is shaped, respectively, for palmar application against the hand of Figure 1, and for back application against the hand of Figure 2 ,
• Figures 5 and 6 are side views showing the position of the ribs in the case of palmar and dorsal application,
• FIG. 7 is a plan view from above showing the various elements making up the orthosis,
• FIG. 8 is a plan view from above of the envelope when it is flat,
• Figures 9 and 10 are perspective views showing the orthosis when it is in place and strapped, respectively in the context of a back application and in the context of a palmar application.

As shown in Figure 7, the orthosis according to the invention is composed of a flexible envelope 2, at least two rigid fishplates 3a, 3b and three independent straps, namely a distal strap 4, an intermediate strap 5 and a proximal strap 6.

The flexible envelope 2 is composed, on the skin side, of a sheet of anallergic material, not shown, and, on the outside, of a sheet 7 having external loops over its entire surface. These two plies are linked to each other by a peripheral seam 8 also ensuring the attachment of a braid 9. A ply 10, also in loop pile with the loops facing outward, is fixed by seams 11 on the central part of the envelope 2, that is to say on the part capable of coming against the back of the hand or against the palmar face of the latter. The seams 11 delimit two longitudinal pockets 12a, 12b, of the same length and having parallel proximal ends, closed by a transverse seam, and a distal end open and opening out from the distal part of the orthosis.

The envelope 2 has a length allowing it to extend longitudinally from the line S to below the wrist and the pockets 12a extend over its entire length. It is extended on the front of the pockets by a flap 13, the skin side part of which is made of loop pile. This flap comprises, on its face which is external when it is an extension of the envelope 2, a ply 14 of hooks able to cooperate with the loops of the pockets.

The two rigid fishplates 3a and 3b are made of metal or synthetic material. They have different lengths, that 3a being longer than that 3b. Near its distal end, each of the ribs is bent to form, with its distal part 15a, 15b, an open "V" adapting to the hand according to the orientation of its concavity, as shown in Figures 5 and 6 .

Each of the independent straps 4, 5, 6 comprises, at least on its outer part, a pile of looped pile 16. The distal strap 4 carries, at each of its ends, sections 17 and 18 respectively of pile velvet with hooks or plastic hooks, while the straps, respectively, intermediate 5 and proximal 6, comprise, at one end, a section of hook pile velvet 19 and, at the other end, a loop 20, improving the tightening.

FIG. 8 shows that, when the ribs 3a, 3b are fully engaged in the pockets 12a, 12b, and that the flap 13 is folded over the envelope 2 so that its hinge 22 remains in contact with the end of each sides, this hinge is not perpendicular to the longitudinal axis x'-x of the orthosis, but is inclined relative to this axis by an angle a , different from 90 °. This same figure shows that by reversing the position of the ribs 3a, 3b in the pockets 12a, 12b, the inclination can be symmetrically reversed. This therefore makes it possible, as shown in FIGS. 3 and 4, to adapt the inclination of the end of the orthosis, so that the latter is close to the inclination of the metacarpophalangeal joints, represented by the dashed lines S in Figures 1 and 2.

Figures 5 and 6 show that by turning the ribs 3a, 3b in the pockets 12a, 12b, the bent distal part 15a, 15b of the ribs allows their shape to be perfectly adapted to the profile of the hand, whatever the application. , palmar or dorsal.

It emerges from the above that the orthosis according to the invention can be used both in the dorsal position and in the palmar position, on a right hand or on a left hand, by having a distal end which is inclined substantially parallel to the joints. metacarpophalangeal and which, therefore, does not hinder the movement of these joints.

Another advantage of this arrangement is that, with a reduced number of models, for example three, respectively small, medium and large, it is possible to cover all the applications, which reduces the manufacturing costs, the management costs of the stocks, and the cost price of the orthosis.

The orthosis is put in place by positioning it longitudinally so that the hinge 22 is substantially perpendicular to the metacarpophalangeal joint, then by temporarily immobilizing it in this position by means of the distal strap 4. In the case of a palm application, this strap passes under the palm of the hand, as shown in Figure 9, while in a back application, it passes over the back of the hand (Figure 10). Temporary fixing is ensured by applying the hook ends 17 and 18 of the strap 4 to the loops constituting the back of the envelope 2, the back of the pockets 12a, 12b and the back of the flap 13.

It is then proceeded to the establishment of the intermediate strap 5, which is arranged very close to the thumb, then to the establishment of the proximal strap 6. For each of these two straps, the locking is ensured by hooking sections of hooked velvet 19 in the loops of the back of the strap.

At this stage of fitting, and if necessary, the distal strap 4 is adjusted in position.

At the end of the fitting, and as shown in FIGS. 9 and 10, the orthosis is perfectly positioned longitudinally and is wedged in longitudinal translation by the straps, respectively distal 4 and intermediate 5, arranged on either side of the thumb.

The use of independent straps 4 to 6 ensures good positioning of the orthosis, whatever its palmar or dorsal mode of use, whatever the general shape of the hand and wrist and therefore contributes to improving the immobilization of the wrist, without abnormal discomfort.

Thanks to this support, it is not essential that the envelope surrounds the entire wrist, which improves comfort.

The fishplates which, in the embodiment shown, are two in number, can also be three in number and cooperate with three pockets, parallel and juxtaposed, formed on the envelope.

Claims (3)

Ambidextrous, dorsal or palmar wrist orthosis, composed of a flexible envelope (2) extending longitudinally from the metacarpophalangeal joints to below the wrist and comprising several longitudinal, parallel and juxtaposed pockets (12a, 12b) for ribs (3a, 3b), this envelope having at least locally plies of velvet with loops capable of cooperating with plies of velvet with hooks carried by transverse holding straps, characterized in that the pockets (12a, 12b) are produced in the central part of the envelope (2), able to come on the back of the hand or under the hand, are provided with proximal ends, closed and parallel, and open distal ends, while, firstly , the ribs (3a, 3b) are each provided with a bent distal part (15a, 15b) capable of marrying the back or the inside of the hand, are rigid, removable and returnable in their pocket, and have long ueurs different so that, when fully engaged in their respective pockets, the straight line S joining their distal ends is substantially parallel to the axis of distribution of the metacarpophalangeal joints, that secondly, the envelope (2 ) is extended beyond the open part of the pockets (12a, 12b) by a closing flap (13) provided with hooking means on the pockets and a flexible hinge (22) suitable, by pressing on the distal end of the ribs (3a, 3b), to bend substantially parallel to the axis (S) of distribution of the metacarpophalangeal joints, plumb with which this hinge is disposed, and that, thirdly, the straps of support are independent of the envelope and include a distal strap (4) cooperating with the thumb and two transverse straps, respectively, intermediate (5) and proximal (6). Universal orthosis according to claim 1, characterized in that the pockets (12a, 12b) are constituted by a sheet (10) of loop pile fixed (11) on the flexible envelope (2), while the flap (13) , also consisting of a pile of loop pile, the loops of which are external, comprises, on the internal face of its end, a layer (14) of hooks capable of cooperating with the loops of the pockets. Orthosis according to all of claims 1 and 2, characterized in that the cover (2) is composed, on the skin side, of a sheet (7) of anallergic material and, on the outside, of a sheet having external loops over its entire surface and constituting attachment means for the ends, provided with hook ply (17, 19), straps (4 to 6).

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